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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
81

A PILOT STUDY ON THE EFFECT OF A COMMUNITY-BASED LIFESTYLE INTERVENTION FOR MIDDLE SCHOOL STUDENTS WHO ARE "AT RISK" FOR TYPE 2 DIABETES

Startzer, Rebecca Faith 01 January 2008 (has links)
AN ABSTRACT OF THE THESIS OF Rebecca Startzer, for the Master of Science degree in Community Nutrition, presented on November 6, 2008, at Southern Illinois University Carbondale. TITLE: A PILOT STUDY ON THE EFFECT OF A COMMUNITY-BASED LIFESTYLE INTERVENTION FOR MIDDLE SCHOOL STUDENTS WHO ARE "AT RISK" FOR TYPE 2 DIABETES MAJOR PROFESSOR: Dr. Sharon Peterson The prevalence of childhood Type 2 Diabetes Mellitus (T2DM) has increased by 33% over the last 15 years (Kaufman, 2002). With the growing number of adolescents with T2DM, it is important to identify adolescents who are "at risk" for T2DM and develop programs to help delay or prevent T2DM. Our pilot study, "R .U. A. Healthy Kid?" sought to examine the relationship of middle school students "at risk" for T2DM and lifestyle factors, including family meals, physical activity, and "screen time" in an effort to reduce their risk through a community-based intervention. At baseline a significant negative correlation was found between "screen time" levels and fruit (p= 0.041) and vegetable (p = 0.046) intake and a significant positive correlation between "screen time" levels and physical activity levels (p=0.006). At three months, a significant positive correlation was found between family meals at home and vegetable intake increased (p=0.024) and a significant positive correlation between family meal frequency increased and physical activity levels (p=0.047). From baseline to three months, frequency of family meals at home decreased (p=0.021). From this study, it could be concluded that improving "at risk" adolescent's behaviors related to family meals, physical activity, and "screen time" levels are critical while developing successful interventions for adolescents "at risk" for T2DM.
82

A Pilot Study on the Effects of a Community-Based Lifestyle Intervention on Emotional Eating and Body Image Disparities Among Adolescents Who Are Overweight and "At-Risk" For Type 2 Diabetes

Humann, Colleen Marie 01 January 2008 (has links)
Previous studies have shown that overweight and obesity in youth and adolescents is one of the leading risk factors for developing Type 2 diabetes mellitus (T2DM). Besides being "at–risk” for T2DM, the possibility also exists for development of major psychological issues. Thus, overweight adolescents who are "at–risk” for T2DM may have increased levels of emotional eating, and poor self–esteem and body image. The design of this pilot study ("R. U. A Healthy Kid”) was a prospective cohort of 17 free–living middle school students "at–risk” for T2DM. Each participant was previously screened and found to have three or more risk factors for T2DM. The intervention targeted four main topics: Family Meals, Healthy Snacks, Physical Activity and "Unique U” (emotional eating, self–esteem, body image and stress management). The "Unique U” component forms the basis of the current study. After three months in the program, participants’ self–esteem significantly increased since the beginning of the program. Many relationships were found between self–esteem, body image, stress and emotional eating questions. Community– based lifestyle interventions that include issues such as improving self–esteem, body image, stress and emotional eating are critical in helping adolescents who are "at–risk” for T2DM.
83

The effects of a plant-based diet on diabetes mellitus

Descovich O'Hare, Caitlin Marie 12 July 2017 (has links)
Diabetes is a global epidemic that has unfortunately been significantly increasing in number of cases annually. It is currently the 7th leading cause of death in the United States and leads to many further complications including cardiovascular disease, neuropathy, retinopathy, and kidney failure. With the increase in Western dietary patterns there has been a subsequent rise in both obesity and diabetes. In fact, type 2 diabetes makes up 90% of diabetes cases and is, in most cases, preventable with lifestyle changes and weight loss. The aim of this review is to look at the option of a plant-based diet as a means of prevention and treatment for type 2 diabetes. In order to understand type 2 diabetes the basics of pathophysiology, risk factors, statistic, complications and current treatments is discussed. Based on an analysis of a low-fat, plant-based diet compared to current conventional type 2 diabetes treatments there is evidence that a vegan diet increases insulin sensitivity, decreases body weight, lowers cardiovascular risk factors, and decreases need for oral antidiabetic treatments. A review of the efficacy of a plant-based diet for treatment and prevention of type 2 diabetes is also discussed in-depth. Further studies may be helpful to validate adopting a low-fat, plant-based diet in treatment of type 2 diabetes. Overall, it is important for physicians to address the individual needs of their patients and allow for the option of lifestyle changes with adequate guidance and support.
84

A genetic analysis of molecular traits in skeletal muscle

Taylor, Dennis Leland January 2018 (has links)
Genome Wide Association Studies (GWASs) have identified variants associated with disease that promise to deliver insights into disease aetiology. However, because many GWAS variants lie in non-coding genomic regions, it is difficult to define the genes and pathways underlying a GWAS signal. The possibility of linking GWAS variants to molecular traits, combined with the development of high throughput assays, has motivated the mapping of molecular quantitative trait loci (QTLs), genetic associations with molecular traits such as gene expression (eQTLs) and DNA methylation (mQTLs). The Finland-United States Investigation of NIDDM (FUSION) tissue biopsy study is motivated by the desire to understand the molecular pathogenesis of Type 2 diabetes (T2D), a complex disease where the vast majority of the ~100 independent GWAS loci occur in non-coding regions. To elucidate the molecular mechanisms underlying these signals, we collected skeletal muscle biopsies, a T2D-relevant tissue, from 318 extensively phenotyped individuals who exhibit a range of glucose tolerance levels. From these biopsies, we generated genotype, gene expression, and DNA methylation information, enabling us to directly measure the effects of T2D on molecular traits, and to link non-coding T2D GWAS loci to candidate molecular targets. In this thesis, I present a catalogue of genetic effects on gene expression and DNA methylation. I use this catalogue firstly, to reveal basic biology of the genetic regulators of skeletal muscle molecular traits, and secondly, to identify molecular traits that are relevant to T2D, glycemic, and other complex traits. In regards to basic biology, I characterise the broader genomic context of QTLs by calculating the enrichment of QTLs in chromatin states across a diverse panel of cell/tissue types. I also identify key skeletal muscle transcription factors (TFs) and classify them as activators or repressors by aggregating the effects of QTLs predicted to perturb TF binding sites. In addition, I characterise the properties of methylation sites associated with gene expression and use inference models to dissect these methylation-expression relationships, classifying cases where the genetic effect is mediated by methylation, expression, or is independent. I also integrate molecular trait genetics with complex traits. First, I perform a conditional analysis, mapping GWAS variants for T2D and glycemic traits to molecular traits, prioritising disease relevant skeletal muscle molecular traits. Second, recognising QTLs may also be specific to a disease state or environmental context, I leverage the rich phenotyping of participants to map genotype by environment (GxE) effects on gene expression—eQTLs that exhibit effects specific to an environmental context. Altogether, these analyses form a thorough survey of the genetic regulators of skeletal muscle expression and DNA methylation, and provide an important resource for interpreting complex diseases.
85

Cellular regulation of cortisol in vivo by 11-beta hydroxysteroid dehydrogenase type 1

Anderson, Anna Jane Claire January 2017 (has links)
Glucocorticoid excess as a result of Cushing’s syndrome or pharmacological treatment can result in the development of obesity and type 2 diabetes mellitus (T2DM). The reactivation of cortisone to cortisol is catalysed by 11βHSD1 which is expressed widely but notably in adipose tissue and liver. Studies have shown dysregulation of cortisol in these tissues with obesity potentially promoting the development of T2DM. Inhibition of 11βHSD1 has been attempted as a novel treatment for T2DM with observed improvement in glycaemic control, body weight and blood pressure. The efficacy of such agents has been disappointing with few reaching phase 2 trials. With recent evidence of bidirectional activity of 11βHSD1 in vivo it becomes apparent that dysregulation may occur at an intracellular rather than tissue level. In this thesis I address several key outstanding questions concerning the physiology and regulation of 11βHSD1 including: 1. Whether combined therapy with metformin alters 11βHSD1 activity and obscures the efficacy of 11βHSD1inhibitors; 2. Whether the contribution of 11βHSD1 to local cortisol concentrations has been under-estimated by considering total rather than free cortisol turnover; and 3. Whether recycling between cortisol and cortisone in adipose tissue and skeletal muscle in obesity is a neglected feature of 11βHSD1 biochemistry and function. Eight obese healthy men with and without type 2 diabetes were recruited to a randomised placebo controlled cross over trial. They received 4 weeks treatment with metformin and placebo. Participants with T2DM additionally received gliclazide as a further control. Using the deuterated tracer D4-cortisol 11βHSD1 activity was measured. Metformin treatment increased whole body 11βHSD1 in both groups postulated as a result of improved insulin sensitivity. 11βHSD1 is located within cells and so contributes to free tissue cortisol concentrations but perhaps less so to total (protein-bound) cortisol in plasma. It has been shown that 11βHSD1 contributes almost half of total circulating cortisol concentrations at rest. This measurement relied upon blood sampling during steady state deuterated cortisol (D4-cortisol) infusion with measurements of total (free plus protein bound) cortisol which may have underestimated true 11βHSD1 activity. This was therefore investigated by comparing 11βHSD1 activity as calculated using total compared with free cortisol tracer enrichments. Equilibrium dialysis was performed separating free from bound portions in plasma samples taken from healthy volunteers who received D4-cortisol infusion. Analysis revealed similar measurements of 11βHSD1 activity using free compared with total cortisol implicating rapid turnover of glucocorticoids between the free and bound pools. On first discovery 11βHSD1 was seen to be a dehydrogenase enzyme in vitro. Later work recognised reductase activity in vivo and up until recently 11βHSD1 has been viewed as a predominantly reductase enzyme. As with other enzymes in the same family, the ability to catalyse both reductase and dehydrogenase depends upon the availability of substrate and co substrate. Whether dysregulation of 11βHSD1 in the settings of obesity and T2DM is the result of alteration in directionality at a cellular level is not known. Firstly bidirectional activity of 11βHSD1 was confirmed in vitro using HEK-293 cells stably transfected with 11βHSD1. The influence of obesity and acute perturbation with hyperinsulinaemia was subsequently investigated in vivo in a random order cross over single blinded case control study involving ten normal weight and ten obese healthy male volunteers. D4-cortisol and deuterated cortisone (D2-cortisone) were infused for the measurement of reductase and dehydrogenase activity of 11βHSD1 respectively with measurements taken across forearm muscle and abdominal subcutaneous adipose tissue. Across whole body, lean and obese individuals displayed similar 11β-reductase and 11β-dehydrogenase activity. Across tissue, 11β-reductase and 11β-dehydrogenase activity was different from zero across adipose tissue in obese individuals and across skeletal muscle in lean individuals providing further evidence of tissue specific differences in 11βHSD1 with obesity. With the addition of hyperinsulinaemia, reductase and dehydrogenase activity was somewhat increased in lean individuals although there was no statistically significant difference between lean and obese individuals. Across tissue there was a trend for obese individuals to display increased 11β-reductase activity across adipose tissue with hyperinsulinaemia. Comparing the rates of reductase and dehydrogenase activity revealed predominantly reductase activity across tissue in obese and dehydrogenase activity in lean individuals. The development of direction specific inhibitors targeting reductase activity by 11βHSD1 may prove efficacious for the treatment of obesity. In conclusion, 11βHSD1 acts as a bidirectional enzyme in vitro and in vivo. Overall directionality of enzyme activity is altered in a tissue specific manner in the setting of obesity. We have shown that this intracellular regulation of cortisol is reflected equally in the metabolically active free pool and total plasma pool. The efficacy of 11βHSD1 inhibitors as novel agents for the treatment of T2DM and coexisting obesity is not diminished by co-prescription with metformin but may prove more efficacious through the development of reductase specific inhibitors.
86

The epidemiology of chronic liver disease in older people with type 2 diabetes mellitus : the Edinburgh Type 2 Diabetes Study

Morling, Joanne Rebecca January 2015 (has links)
Increasingly chronic liver disease is being acknowledged as a complication of type 2 diabetes, in particular non-alcoholic fatty liver and non-alcoholic fatty liver disease. Rates of non-alcoholic fatty liver are higher in people with type 2 diabetes than in the general population, with prevalence rates believed to be between 40-70%. Given the aging Scottish population and the obesity driven diabetes epidemic, the problem of chronic liver disease is likely to increase. Despite this there has been little investigation into the natural history of nonalcoholic fatty liver disease and the risks of clinically significant chronic liver disease in community based cohorts because diagnosis has been heavily reliant on liver biopsy. The use of liver biopsy is limited in both research and clinical practice due to its associated high mortality (1/1000) and morbidity and also due to practical limitations (sampling variability, semi-quantitative scoring systems). As a result the use of non-invasive markers of liver injury (non-specific liver injury, steatosis, steatohepatitis, liver fibrosis and surrogates of advanced portal hypertension) are rising, in the diagnosis of chronic liver disease, however, their utility in both community cohorts and patients with type 2 diabetes has not been widely studied. The aims of the studies presented in the thesis, using the Edinburgh Type 2 Diabetes Study, were: (i) to describe the distributions of a range of non-invasive markers of steatohepatitis and liver fibrosis in older people with type 2 diabetes, their relationship with metabolic and liver disease risk factors, and to compare the agreement of different non-invasive markers of hepatic fibrosis; (ii) to determine the frequency (prevalence and incidence) of and risk factors for clinically significant chronic liver disease in people with type 2 diabetes; and (iii) to determine the importance of chronic liver disease as a risk factor (or risk marker) for cardiovascular mortality or morbidity in type 2 diabetes. Prior to undertaking this work I undertook a detailed systematic review of the literature relating to the use of non-invasive markers of hepatic fibrosis to inform the choice of markers used in the study. Examination of a wide range of potential markers of steatohepatitis and liver fibrosis found varied relationships with diabetes history. Most commonly, elevated markers of steatohepatitis and liver fibrosis were associated with older age and higher body fat measures. However, most of these relationships between liver markers and body fat measures lost statistical significance when limiting the population to only those with hepatic steatosis and/or non-alcoholic fatty liver disease. There were marked differences in the associations between different liver fibrosis markers and potential diabetes and metabolic risk factors, suggesting that these markers are not actually measuring the same underlying “fibrosis” condition. There was poor correlation between the five markers of liver fibrosis studied. Using the top vigintile (5%) of each marker resulted in excellent agreement on the absence of advanced liver disease but poor agreement on the presence of advanced liver disease. The prevalence of clinically significant CLD (defined as cirrhosis, HCC or gastrooesophageal varices) was 2.2% - 0.9% diagnosed prior to enrolment with an additional 1.4% identified by study investigations. Over nearly 6 years of follow-up, only 1.4% of the cohort developed incident clinically significant CLD. Higher levels of systemic inflammation, steatohepatitis and hepatic fibrosis markers were associated with both unknown prevalent and incident clinically significant chronic liver disease. Less than half of participants developing incident significant disease were identified as high risk by the study investigations. Abnormal liver enzymes were statistically significantly associated with incident cases, however the presence of hepatic steatosis was not. There were 372/1033 (36.0%) patients with prevalent CVD and 319 (30.9%) with prevalent CAD at baseline. After mean follow-up of 4.4 years there were 44/663 incident CVD events, including 27 CAD events. There were 30/82 CVD related deaths. However, risk of dying from or developing CVD was no higher in subjects with steatosis than in those without. There was also no statistically significant relationship between CVD and steatohepatitis or liver fibrosis. The only statistically significant relationship between CVD and any liver markers was with GGT (prevalent CVD, OR 1.28, p=0.007; incident CAD, OR 2.35, p=0.042), suggesting that in our study population, CLD may have little effect on the development of, or mortality from, CVD. In conclusion, the potential for using non-invasive biomarkers to diagnose clinically significant chronic liver disease in type 2 diabetes remains limited, however chronic liver disease is a significant problem in older people with type 2 diabetes and is frequently undiagnosed.
87

Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru

Crispín Trebejo, Brenda, Robles Cuadros, María Cristina, Bernabe-Ortiz, Antonio 10 June 2015 (has links)
maria.cristina.rc2690@gmail.com / Article / Introduction: There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Methods: Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: < 7% versus ≥ 7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire-9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders. Results: A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%–14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%–30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR = 1.32; 95% CI 1.15–1.51) after adjusting for several potential confounders. Conclusions: There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications. / We would like to thank Dr Viviana Ulloa who helped us to access data and T2D patients, and Dr Percy Mayta- Tristan for revising initial versions of the manuscript. AB-O is supported by Wellcome Trust Research Training Fellowship in Public Health and Tropical Medicine (Grant number 103994/Z/14/Z). / Revisión por pares
88

Functional analysis of type 2 diabetes associated transcripts

Richards, Hannah B. January 2014 (has links)
Genome wide association studies (GWAS) have transformed the study of the heritability of complex diseases such as type 2 diabetes (T2D), with the current tally of established risk loci close to ninety. Each of these loci has the potential to offer novel insights into the biology of this disease, and opportunities for clinical exploitation. However, the complexity of T2D has often frustrated efforts to achieve these functional and translational advances. This thesis aims to delve into the functional characterisation of two known susceptibility loci, KLF14 and ADCY5, and describe findings relevant to disease pathology. KLF14 and ADCY5 are two loci associated with T2D predisposition working through disparate mechanisms. Variants at the maternally imprinted KLF14 locus are associated with measures of insulin resistance and expression data has implicated KLF14 as a master regulator of genes in adipose tissue. In contrast, variation at the ADCY5 locus is associated with impaired beta cell function, high fasting glucose, and low birth weight suggesting ADCY5 is having an effect on insulin secretion. In this thesis, ENU mouse models of these two genes are investigated functionally to elucidate more about the pathology of common human variation at these loci. A mouse model was derived with an ENU point mutation at Adcy5 Y1064C. Phenotyping of this model revealed improved oral glucose tolerance, and secretion studies from isolated islet cells demonstrated impaired glucagon secretion from mice homozygous for the Y1064C mutation in the presence of adrenaline. These results suggest that Adcy5 is involved in glucagon regulation in the alpha cell. The Adcy5 Y1064C confers a protective effect against hyperglycaemia in mouse indicating that the T2D risk allele at the ADCY5 locus in humans may have the opposite direction of effect. A mouse model containing the ENU point mutation Klf14 R238L predicted to be disruptive to KLF14 protein function showed no significant difference in body weight, measures of insulin resistance, or blood cholesterol. However, expression of several genes associated in trans with variation near KLF14 in humans was changed in adipose tissue and skeletal muscle when the R238L mutation was inherited maternally compared to mice which had inherited the mutation paternally or carried two wild type alleles. This result suggests a mechanism by which Klf14 is regulating genes across metabolic tissues.
89

AvaliaÃÃo do risco para diabetes mellitus tipo 2 entre adultos de Itapipoca-Cearà / Evaluation of the risk for type 2 diabetes mellitus among adults in itapipoca town-CearÃ

Niciane Bandeira Pessoa Marinho 16 December 2010 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / O diabetes mellitus tipo 2 à uma doenÃa de importÃncia crescente na saÃde pÃblica, jà que sua incidÃncia e prevalÃncia tÃm avanÃado de forma assustadora, sendo causada por uma combinaÃÃo de fatores genÃticos e estilo de vida. Em face disso, a saÃde pÃblica indica a prevenÃÃo primÃria para identificar os fatores de risco para DM2 e traÃar estratÃgias com vistas a evitar a exposiÃÃo ao risco, retardando ou impedindo o aparecimento da doenÃa. Objetivou-se avaliar o risco para o desenvolvimento do DM2 entre adultos de Itapipoca-CE. Trata-se de pesquisa quantitativa, com delineamento transversal e observacional, realizada no perÃodo de janeiro a marÃo de 2010, com 419 usuÃrios da EstratÃgia SaÃde da FamÃlia do municÃpio de Itapipoca-CE, com idades entre 20 e 59 anos. Para a coleta de dados aplicou-se um formulÃrio no qual se registraram dados sociodemogrÃficos e clÃnicos e o Finnish Diabetes Risk Score. Os dados foram armazenados no Excel, sendo processados no Statistical Package for Science Social versÃo 18.0. O estudo foi aprovado pelo Comità de Ãtica em Pesquisa da Universidade Federal do Cearà sob protocolo 346/09. Dos 419 usuÃrios participantes, 88,1% eram do sexo feminino; a mÃdia de idade foi de 37 anos; 60,4% eram casados ou mantinham uniÃo estÃvel; 39,4% cursaram atà o ensino fundamental incompleto e 58,2% pertenciam Ãs classes econÃmicas D/E. Em relaÃÃo aos fatores de risco para DM2, 25,3% tinham idade &#8805; 45 anos; 59,7% estavam com excesso de peso; 84% foram classificados em risco cardiovascular; 83,3% eram sedentÃrios; 53,7% relataram nÃo comer frutas e/ou verduras diariamente; 12,9% tomavam anti-hipertensivos; 5,3% mencionaram histÃria prÃvia de glicose alta e 47% histÃria familiar de DM2. Segundo observou-se, 5,2% da amostra foram classificados com hipertensÃo e apenas 0,7% com provÃvel diabetes. Quanto ao grau de risco para DM2, 24,6% estavam em baixo risco; 63% em risco moderado e 11,7% em alto risco. Entre os participantes com alto risco, 12,0% eram homens; 30,2% tinham idades &#8805; 45 anos; 37,4 estavam com excesso de peso; 21,1% estavam em risco cardiovascular aumentado; 12,9% eram sedentÃrios; 14,7% nÃo comiam frutas/verduras diariamente; 31,5% tomavam anti-hipertensivos; 81,8% relataram histÃria de glicose alta e 23,9% histÃria familiar de DM2. Esse estudo abre portas para uma posterior pesquisa de intervenÃÃo no municÃpio, na qual os indivÃduos com alto risco para DM2 seriam acompanhados pelos profissionais de saÃde da ESF e dos NÃcleos de Apoio à SaÃde da FamÃlia, com orientaÃÃes quanto Ãs mudanÃas no estilo de vida, e com intervenÃÃes nos fatores de risco potenciais encontrados, objetivando reduzir ou retardar o aparecimento da doenÃa. / The type 2 diabetes mellitus is a disease of increasing importance in public health, since its incidence and prevalence have dauntingly advanced, and has been caused by a combination of genetic factors and lifestyle. In this view, public health indicates primary prevention to identify risk factors for T2DM and strategize in order to avoid exposure to risk by delaying or preventing the onset of the disease. The objective was to evaluate the risk for the development of T2DM among adults in Itapipoca town-CearÃ. It is a quantitative research with cross-sectional observational study conducted from January to March 2010, with 419 users of EstratÃgia SaÃde da FamÃlia (ESF) in Itapipoca town-CearÃ, the participants aged between 20 and 59 years. To collect data we applied a form in which demographic and clinical data and Finnish Diabetes Risk Score were registered. The data were stored in Excel, and processed in the Statistical Package for Social Science 18.0. The study was approved by the Ethics Committee of the Federal University of CearÃ, under protocol 346/09. Out of the 419 participating users, 88.1% were female and the average age was 37 years, 60.4% were married or had common law-marriage, 39.4% attended to part of primary school and 58.2% belonged to lower social classes. Regarding risk factors for T2DM, 25.3% were aged &#8805; 45 years, 59.7% were overweight, 84% were classified as cardiovascular risk, 83.3% were sedentary, 53.7% reported not eating fruit and / or vegetables daily, 12.9% were taking anti-hypertensive, 5.3% reported a previous history of high glucose and 47% had family history of T2DM. As observed, 5.2% of the sample were classified as having hypertension, and only 0.7% with probable diabetes. As for the risk levels for T2DM, 24.6% were at low risk, 63% in moderate risk and 11.7% at high risk. Amongst participants with high risk, 12.0% were men, 30.2% were aged &#8805; 45 years, 37.4% were overweight, 21.1% were at increased cardiovascular risk, 12.9% were sedentary; 14.7% did not eat fruit / vegetables daily, 31.5% took antihypertensive drugs, 81.8% reported a history of high glucose and 23.9% had family history of T2DM. This study opens doors for further intervention research in the town, in which individuals at high risk for T2DM would be accompanied by health professionals from the ESF and the NÃcleos de Apoio à SaÃde da FamÃlia. With the aim to reduce or delay the onset of the disease, the individuals would be given guidance as to changes in lifestyle and interventions on potential risk factors found.
90

Nurse’s experience of working with HIV-infected people with type 2 diabetes

Lomstad, Mathilda, Möller, Amanda January 2017 (has links)
Human immunodeficiency virus (HIV) is one of the largest public health problems internationally today and southern Africa is the part of the world that is most affected. Successful research has led to new improved antiretroviral drugs. Even if these drugs are improved and more successful, they bring along side effects. Research studies have shown that treatment of HIV entails metabolic changes and increases the risk for developing diabetes. This side effect can have a large impact on the patient’s quality of life and the affected patients often have to make lifestyle changes. To be able to develop the care around this group of patients, it is important to understand the complexity of nursing them. The aim with our study is to look into how nurses in Namibia experience caring for patients with HIV who also has type 2 diabetes as a side effect from antiretroviral drugs. Our study is a qualitative study based on interviews with six nurses working at Katutura hospital in Windhoek, Namibia. We did the interviews at Katutura hospital and the interviews were recorded. We transcribed the interviews and used Lundman &amp; Hallgren Granheims (2012) method for analyzing the collected data. The result showed that health education raises awareness and through that, the prevention of HIV increases and the risk of failure for already infected persons is reduced. Overall shall openness be a leading influencer in every aspect around the patient, the nurses, the community and the family’s treatment. The discussion brings up the importance of educating people both in the community and inside the healthcare spectra. It also brings up the importance of openness, both from the patients and nurses.

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